Volume 4, Issue 2 May 2013
New Study Suggests Benefits from More Than Five years of Tamoxifen
Women diagnosed with early stage, hormone receptor positive breast cancer are usually recommended to take five years of an oral hormonal therapy. For young women who are pre-menopausal, the recommended therapy is generally tamoxifen. Tamoxifen blocks the effect of the hormone estrogen, and prevents new and recurring breast cancer from forming. A recently reported clinical trial found that women who took ten years of tamoxifen compared to the standard five years, had lower rates of breast cancer recurrence (breast cancer coming back) and a longer overall survival, suggesting that a greater number of years on tamoxifen should be seriously considered. The benefits were modest in size, but large enough to be potentially beneficial for some women.
When comparing the two groups (5 versus 10 years of tamoxifen) the researchers found a decreased risk of breast cancer recurrence in the group taking tamoxifen for 10 years. The recurrence rate decreased from 25.1% to 21.4%, for an absolute overall benefit of 3.7%. Researchers also looked at differences in mortality (death) due to breast cancer and found a lower percent of deaths in the 10 year group, 12.1%, compared to 15.0% in the 5 year group, a difference of 2.9%. These benefits were not noted until after the 10th year of follow up, suggesting that tamoxifen has a beneficial effect that lasts several years after women stop taking it. All women were followed for 15 years.
The serious risks of taking 5 versus 10 years of tamoxifen were also studied. Serious risks of tamoxifen are relatively rare and include stroke, blood clots, heart disease, and endometrial cancer. The risk of several of these events was slightly elevated in the 10 year group though it was still particularly low for women who are young (under 50). The trial authors noted the importance of continuing to study the long term serious risks of taking tamoxifen.
The decision to take tamoxifen for an additional five years is a personal one. It should involve weighing the expected benefit of extending therapy against the expected risks. Quality of life factors such as side effects and personal preferences (including desire to be off medication or trying to carry a biologic child) should also be seriously considered. Some side effects associated with tamoxifen, for example, hot flashes, affect some women and not others. Women who experience severe side effects might consider including this as a negative factor in their decision to extend or not extend treatment. Another important consideration is the risk associated with the primary breast cancer diagnosis. Women who are at higher risk of recurrence (larger tumors or lymph node involvement) are more likely to benefit from extended tamoxifen than those with lower risk (small, node negative) tumors.
If you would like to learn more about what is the best option for you, we recommend you make an appointment to meet with your oncologist.
To read the full study, see: Davies C, Pan H, Godwin J, et al. Long-term effects of continuing adjuvant tamoxifen to 10 years versus stopping at 5 years after diagnosis of oestrogen receptor-positive breast cancer: ATLAS, a randomised trial. Lancet 2013: 381, pp 805-16. Young Women Connect Through The Young Adult Program
The Program for Young Women with Breast Cancer is proud to announce the launch of our online interactive community within the Young Adult Program’s website, www.dana-farber-yap.org. This is a space where young women with breast cancer can connect by sharing their thoughts and experiences, asking questions, and supporting each other. The community includes women who are in many different stages of diagnosis, including women currently in treatment and those who are many years out from treatment. If you are interested in joining the online community, please contact Julie at 617-632-3916 or [email protected].
One blogger noted: “It has been great to have people to ask my questions to–people who have been there and get it.”
Another weighed in: “I had a tough couple of years
after my diagnosis. Now, years later, I can be
encouraging to others who are going through it
now.”
Young adults with cancer often face different challenges than those of children and older adults. The mission of the Young Adult Program (YAP) is to provide clinical services and programs that validate and support the needs of young adults with cancer. YAP is committed to easing the emotional burden of living and coping with cancer, empowering young adults to become active participants in their cancer treatment, and providing emotional and social support in the form of educational workshops, conferences, opportunities to network with other young adults with cancer, and clinical mental health services.
For more information about the Young Adult Program, contact Rhian Waterberg at 617-632-6819 or [email protected].
Many Thanks To Carie and Her Crew!
Carie is a 12 year breast cancer survivor who has become an advocate for young women with breast cancer and was an integral part of the establishment of the Young Women’s Program (YWP). Seven years ago, Carie corralled her friends and relatives to ride the Pan-Mass Challenge with her to celebrate her survivorship and raise money for the cause. To date, Carie’s Crew has raised over $500,000 for the YWP. We are so grateful for this wonderful support! To learn more about Carie’s Crew contact Carie at [email protected].
Founded in 1980, the Pan-Mass Challenge (PMC) is an annual bike-a-thon that today raises more money for charity than any other single event in the country. For more information, visit www.pmc.org.
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Intimacy and Sex ______Additional Resources and Information Susan G. Komen for the Cure
Save the Susan G. Komen for the Cure is the world’s largest Date Young Women’s Sexual Health Workshop grassroots network of breast cancer survivors and Sharon Bober, PhD activists working together to save lives, empower Wednesday, May 15, 2013, 5:30-7pm people, ensure quality care for all, and energize science Join Dr. Bober as she discusses common challenges after to find cures. treatment, including decreased sexual desire, body image www.komen.org concerns, menopausal symptoms and communication ______difficulties with partners. To register contact Julie at 617- Young Survival Coalition 632-3916 or [email protected].
Young Women’s Telephone Support Group Liz Farrell, LICSW The Young Survival Coalition (YSC) is an international, For young women looking to connect with others who nonprofit network of breast cancer survivors and understand the impact of living with and beyond breast supporters dedicated to the concerns and issues that cancer. Next session begins in May 2013. For more are unique to young women with breast cancer. information or to register, please contact Julie at 617-632- www. youngsurvival.org 3916 or [email protected]. ______Living Beyond Breast Cancer Facing Forward Julie Salinger, LICSW
For patients that will complete treatment for breast
cancer in 4-6 weeks or those that have completed Living Beyond Breast Cancer (LBBC) is a national treatment within the last 3-4 months. Sessions offered education and support organization whose goal is to year-round. For more information, call Julie S. at 617-632- improve quality of life and help women take an active 8081. role in their ongoing recovery or management of the disease. Living Proof: Celebrating Survivorship www.lbbc.org June 17-20, 2013 ______This annual week-long event honors the challenge and FORCE journey of cancer survivorship. For more information visit www.dana-farber.org/living-proof.
Facing Our Risk of Cancer Empowered (FORCE) is the Annual Young Women’s Forum only national nonprofit organization devoted to Friday, October 18th, 2013 hereditary breast and ovarian cancer. Their mission Details and formal invitations to follow. For more includes support, education, advocacy, awareness, and information contact Julie at 617-632-3916 or research specific to hereditary breast and ovarian [email protected]. cancer. Programs serve anyone with a BRCA mutation or a family history of cancer. Looking for a way to give back to the Program for www.facingourrisk.org Young Women with Breast Cancer and help other ______young women?
Fertile Hope VOLUNTEER!
The One-to-One support network matches individuals
who are facing a new diagnosis with someone who has Fertile Hope is a national LIVESTRONG initiative been there. We are hoping to expand on this program dedicated to providing reproductive information, to create a specialized support system for young support and hope to cancer patients and survivors women with breast cancer. If you are interested in whose medical treatments present the risk of infertility. volunteering, contact Julie at 617-632-3916 or www.fertilehope.org [email protected] for more information.